Association between P-wave terminal force in lead V₁ and extent of left atrial low-voltage substrate in older patients with paroxysmal atrial fibrillation.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-08-01 Epub Date: 2023-11-30 DOI:10.1007/s10840-023-01710-w

Yue Qiu, Jinyu Sun, Yuxuan Wang, Caiyi Jin, Weizhu Ju, Gang Yang, Kai Gu, Hailei Liu, Zidun Wang, Xiaohong Jiang, Mingfang Li, Hongwu Chen, Minglong Chen

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引用次数: 0

Abstract

Background: The P-wave terminal force in lead V₁ (PTFV₁) is a marker of cardiomyopathy and risk of atrial fibrillation (AF). Low-voltage area (LVA) in the left atrium (LA), which indicates underlying atrial fibrosis, could predict AF recurrence. This study aimed to investigate the correlation between PTFV₁ and LVA in older patients with paroxysmal AF.

Methods: From May 1, 2020, to October 31, 2021, a total of 162 patients aged 65-80 years with paroxysmal AF who underwent index ablation procedures were enrolled. PTFV₁ was measured in sinus rhythm (SR) using 12-lead electrocardiograms prior to the ablation. Abnormal PTFV₁ was defined as a ≥ 4 mVms depression. Additional LVA ablation beyond circumferential pulmonary vein isolation (CPVI) was performed if LVAs were found.

Results: Among the 162 patients, 88 had a normal PTFV₁ and 74 had an abnormal PTFV₁ prior to ablation. There was a significant difference in LVA in patients with and without an abnormal PTFV₁ (LVA, 11.0 vs. 5.1 cm², P < 0.001; LVA burden, 8.9% vs. 4.5%, P < 0.001). PTFV₁ and PTAV₁ were highest in the upper tertile with extensive LVAs (P < 0.001). Multivariate analysis revealed that abnormal PTFV₁ was an independent predictor of LVAs (β = 4.961; 95% CI, 2.135-7.788; P < 0.001). After a median follow-up of 23 months, the AF-free survival rate was similar between the normal PTFV₁ group and the abnormal PTFV₁ group (13/88 vs. 12/74, hazard ratio [HR], 0.933 [95% CI, 0.425-2.047]; P = 0.861).

Conclusions: Abnormal PTFV₁ at baseline was independently associated with the extent of LVA in older patients with paroxysmal AF.

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老年阵发性心房颤动患者V1导联p波终末力与左房低压底物范围的关系

背景:V1导联p波末端力(PTFV1)是心肌病和房颤(AF)风险的标志。左心房低压区(LVA)提示心房纤维化，可预测房颤复发。本研究旨在探讨老年阵发性房颤患者PTFV1与LVA的相关性。方法:从2020年5月1日至2021年10月31日，共纳入162例65-80岁的阵发性房颤患者，他们接受了指数消融手术。消融前使用12导联心电图测量窦性心律(SR) PTFV1。PTFV1异常定义为≥4 mvm的抑郁。如果发现LVAs，则在环肺静脉隔离(CPVI)之外进行额外的LVA消融。结果:162例患者中，消融前PTFV1正常88例，PTFV1异常74例。有和没有PTFV1异常的患者的LVA有显著差异(LVA, 11.0 vs. 5.1 cm2, p1和PTAV1在广泛LVAs的上五分之一中最高(p1是LVAs的独立预测因子(β = 4.961;95% ci, 2.135-7.788;1组与PTFV1异常组(13/88∶12/74，风险比[HR]， 0.933 [95% CI, 0.425 ~ 2.047];p = 0.861)。结论:老年阵发性房颤患者PTFV1基线异常与LVA程度独立相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.